EARLY DIAGNOSIS AND PREVENTION OF INFECTIONS IN CIRRHOSIS.

IF 4.3 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Seminars in liver disease Pub Date : 2022-06-07 DOI:10.1055/a-1869-7607

A. Kulkarni, M. Premkumar, J. Arab, Karan Kumar, Mithun Sharma, N. Reddy, N. Padaki, R. Reddy

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引用次数: 13

Abstract

Cirrhosis is a risk factor for infections. Majority of hospital admissions in patients with cirrhosis are due to infections. Sepsis is an immunological response to an infectious process that leads to end-organ dysfunction and death. Preventing infections may avoid the downstream complications and early diagnosis of infections may improve the outcomes. In this review, we discuss the pathogenesis, diagnosis, and biomarkers of infection, as well as incremental preventive strategies for infections and sepsis and consequent organ failures in cirrhosis. Strategies for primary prevention include reducing gut translocation by selective intestinal decontamination, avoiding unnecessary proton pump inhibitors' use, appropriate use of beta-blockers and vaccinations for viral diseases, including coronavirus disease-2019. Secondary prevention includes early diagnosis and timely and judicious use of antibiotics to prevent organ dysfunction. Organ failure support constitutes tertiary intervention in cirrhosis. In conclusion, infections in cirrhosis are potentially preventable with appropriate care strategies to then enable to improve outcomes.

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肝硬化感染的早期诊断和预防。

肝硬化是感染的危险因素。大多数肝硬化患者入院是由于感染。脓毒症是对感染过程的免疫反应，导致终末器官功能障碍和死亡。预防感染可避免下游并发症，早期诊断感染可改善预后。在这篇综述中，我们讨论了感染的发病机制、诊断和生物标志物，以及肝硬化感染、败血症和随之而来的器官衰竭的渐进式预防策略。一级预防策略包括通过选择性肠道去污来减少肠道易位，避免不必要的质子泵抑制剂的使用，适当使用β受体阻滞剂和针对病毒性疾病(包括2019冠状病毒病)接种疫苗。二级预防包括早期诊断和及时、明智地使用抗生素，以防止器官功能障碍。器官衰竭支持是肝硬化的三级干预措施。总之，通过适当的护理策略，肝硬化感染是可以预防的，从而能够改善结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in liver disease 医学-胃肠肝病学

CiteScore

8.20

自引率

2.40%

发文量

期刊介绍： Seminars in Liver Disease is a quarterly review journal that publishes issues related to the specialties of hepatology and gastroenterology. As the premiere review journal in the field, Seminars in Liver Disease provides in-depth coverage with articles and issues focusing on topics such as cirrhosis, transplantation, vascular and coagulation disorders, cytokines, hepatitis B & C, Nonalcoholic Steatosis Syndromes (NASH), pediatric liver diseases, hepatic stem cells, porphyrias as well as a myriad of other diseases related to the liver. Attention is also given to the latest developments in drug therapy along with treatment and current management techniques. Seminars in Liver Disease publishes commissioned reviews. Unsolicited reviews of an exceptional nature or original articles presenting remarkable results will be considered, but case reports will not be published.